Billions of dollars are spent annually on traditional pain treatments, but adequate management of chronic pain continues to present a challenge. People with chronic pain, often after being disillusioned by traditional interventions, increasingl seek complementary pain treatments. The use of music as a non-pharmacological pain treatment has received growing attention during the past two decades. Unfortunately, research on the use of music for pain management has focused primarily on listening to pre-recorded music. While it is true that listening to music can function as a distractor or a relaxing agent, or clinical experience indicates that patients' active engagement in music therapy enlists added components of effective pain management. Specifically, we have developed a vocal music therapy (VMT) treatment program that activates mechanisms important for im- proved physical and emotional functioning and self-efficacy for people with chronic pain management needs. These mechanisms include augmented body awareness, readiness to work with the body rather than against it, increased acceptance, improved emotional expressivity, enhanced mood, increased joy and energy, and enhanced social support. Our 8-week VMT treatment program uses clinically tested techniques including ton- ing (singing of elongated vowels), group singing, and deep breathing. The purpose of this exploratory study is to test the feasibility, acceptance, and treatment effects of VMT with people who experience chronic pain. Us- ing a wait-list control group design, we will randomize 48 inner-city adults with chronic pain to the VMT treat- ment group or the standard care wait-list control (WLC) group. We will: 1) evaluate the size of the effects of VMT, compared with standard care, on physical functioning as the primary outcome and self-efficacy, pain in- tensity, pain coping, emotional functioning, patient perception of change, and healthcare consumption as sec- ondary outcomes. Outcome measures will be administered at baseline, 4 weeks, 8 weeks, and one-month fol- low-up; 2) evaluate the feasibility and acceptance of the VMT treatment program, as well as the WLC group design; and 3) obtain qualitative participant feedback on the treatment protocol and perceived benefits through a focus group during the one-month follow-up session. The results from this study will be used to support de- sign decisions for a future full-scale randomized controlled trial. If the findings of this proposed pilot study are positive and are replicated in larger trials, VMT could become an attractive, cost-effective adjunctive treatment option with no side-effects or complications. Furthermore, population groups, such as African-Americans and Latinos, for whom community music making is an integral part of their culture may view VMT as a desirable complementary treatment option for their chronic pain management needs. PUBLIC HEALTH RELEVANCE: Chronic pain affects more than 35% of the U.S. population and carries an estimated healthcare expense of $413 billion. Because traditional pain treatments often fail to bring adequate pain relief, people with chronic pain increasingly seek complementary pain treatments. This study will test the feasibility and effects of a vocal music therapy treatment program that was developed specifically to improve the physical and emotional functioning and self-efficacy of people with chronic pain.